Objective: To introduce an open source software for the electrophysiological analysis of tremor.

Background: The last MDS consensus on tremor in 2018 proposed a tremor classification along two axes, clinical and etiological. One of the tools proposed for the clinical characterization is electrophysiology. The electrophysiological characterization of tremors, although proven to be very useful, is not widely available.  The tools needed to do this kind of study are the hardware (an amplifier with at least 6 channels, surface electrodes and two accelerometers) and the software to process the data. The hardware for acquisition of EMG is usually available in neurology clinics and the accelerometers can be obtained at low cost. The software for data analysis is not usually available and this may be a barrier for wide adoption of tremor studies. Our purpose was to develop a website with a software for data processing needed for the tremor analysis.

Method: Using “R” programing language we developed software for tremor analysis. The software is designed to read 1 accelerometer (ACC) channel and 2 electromyographic (EMG) channels for each forearm (total of 2 ACC and 4 EMG). The input is a text file with the channel information in columns. The user will be able to display the data in time series in interactive plots, perform fast Fourier frequency transformation of the channels and do coherence analysis. By analyzing data recorded in different conditions (rest, posture, posture plus weight loading, action) it is possible to identify the mechanical, mechanical reflex and central component of the tremor. The coherence analysis helps to find tremor components originating from common oscillators. The combined information from the time and the frequency domains can facilitate diagnosis of essential tremor, enhanced physiological tremor, functional tremor, orthostatic tremor as well as identification of dystonic and myoclonic activity inside the tremor.

Results: The software will be published on a website so clinicians will be able to do the tremor analysis online. The codes of the software will also be available for further improvement by the community.

Conclusion: The electrophysiological study of tremor is a valuable tool for characterization of tremor. We are providing a free open source tool for tremor analysis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/tremoroton-a-new-open-source-tool-for-tremor-analysis/